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Foreign Aid Donors Should Prioritize Maternal Mortality In Developing Countries, NYT Opinion Piece Says
One of the "most lethal forms of sex discrimination" is the "systematic inattention to reproductive health care, from family planning to childbirth" in developing countries, New York Times columnist Nicholas Kristof writes. According to Kristof, a woman dies every minute somewhere in the world from pregnancy or childbirth complications, and 20 times that number suffer childbirth injuries. Providers of foreign aid, including the U.S., "have never shown much interest in maternal mortality, and impoverished women are typically the most voiceless, neglected people in their own countries -- so they die at astonishing rates," Kristof writes.Kristof highlights the childbirth experience of a 19-year-old Pakistani woman named Shazia Allahdita whose infant died in childbirth after her relatives refused to take her to the hospital because they did not want to pay for the taxi fare. Kristof writes that "[i]f men had uteruses, "paternity wards" would get res, ambulances would transport pregnant men to hospitals free of charge, deliveries would be free, and the Group of Eight industrialized nations would make paternal mortality a top priority." Kristof notes that there is "the dawn of a global movement against maternal mortality," with British Prime Minister Gordon Brown and U.N. Secretary-General Ban Ki-moon working with the U.S. and other countries to plan a "landmark global health session" on Sept. 23. The session will focus, in part, on maternal health, which Kristof terms a "milestone." He concludes, "My dream is that Barack and Michelle Obama will leap forward and adopt this cause -- and transform the prospects for so many young women like Shazia" (Kristof, New York Times, 7/29).
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Cognitive Benefits In Older Adults Who Have Regular Moderate Alcohol Intake

A glass of wine here, a nightcap there - new research out of Wake Forest University School of Medicine suggests that moderate alcohol intake offers long-term cognitive protection and reduces the risk of dementia in older adults. The study is being presented at the Alzheimer"s Association 2009 International Conference on Alzheimer"s Disease (ICAD), in Vienna on July 13. While previous studies have shown that moderate alcohol intake, particularly wine, is linked with lower risk of heart attacks and dementia, most of the studies have been done in middle-aged people, and it has remained unclear if the benefits of alcohol also apply to older adults in general or to older adults who might already have some mild memory problems. This is the largest, longest U.S. study to look at the effects of regular alcohol intake on dementia in seniors, both with and without memory problems. "As of yet, we still have no cure for Alzheimer"s disease and other dementias, so it is important to look for things that might help people prevent the disease," said Kaycee Sink, M.D., M.A.S (Masters of Advanced Studies in clinical research), a geriatrician and senior author of the paper. Moderate alcohol intake has been linked to lower risk of heart attacks, stroke, dementia, and death in middle-aged adults, but there is still controversy about alcohol intake in older adults." For the study, researchers began by examining and interviewing 3,069 individuals, 75 years or older and most without any memory or thinking problems, about their drinking habits. Participants were asked about beer, wine, and liquor. The investigators then categorized the individuals as abstainers (non-drinkers), light drinkers (one to seven drinks per week), moderate drinkers (eight to 14 drinks per week), or heavy drinkers (more than 14 drinks per week). All types of alcohol were included. The study subjects were then examined and interviewed every six months for six years to determine changes in their memory or thinking abilities and to monitor who developed dementia. Researchers found that individuals who had no cognitive impairment at the start of the study and drank eight to 14 alcoholic beverages per week, or one to two per day, experienced an average 37 percent reduction in risk of developing dementia compared to individuals who did not drink at all and were classified as abstainers. The type of alcohol consumed did not matter. For older adults who started the study with mild cognitive impairment, however, consumption of alcohol, at any amount, was associated with faster rates of cognitive decline. In addition, those who were classified in the heavy drinker category, consuming more than 14 drinks per week, were almost twice as likely to develop dementia during the study compared to non-drinkers with mild cognitive impairment. "We were excited to see that even in older adults, moderate alcohol intake decreases the risk of dementia," Sink said. "It is important to note, however, that our study found a significantly higher risk of dementia for heavy drinkers who started the study with mild cognitive impairment." The results are consistent with previous studies of middle-aged adults that suggest mild to moderate alcohol intake may reduce the risk of dementia, except in the case of individuals who already have mild to moderate cognitive impairment. The researchers" findings support current recommendations not to exceed one drink per day for women and two for men. It is unclear from this study whether an abstainer who begins drinking moderately in his/her 70s will experience the same benefit or if the benefit is associated with a long pattern of moderate alcohol intake that continues on into old age. "Our results suggest that older adults who are normal cognitively and drink moderately do not need to change their drinking behavior," Sink said. "If you have mild cognitive impairment however, it might benefit you to restrict your drinking and certainly not exceed one drink a day for women and two drinks a day for men. "The participants in this study self-reported their alcohol intake at the start, but it is unusual for people to start drinking in their 70s, so we assume that the habits they reported at the start of the study reflect stable drinking habits," Sink added. "Without scientific data showing that it is beneficial, I wouldn"t recommend that non-drinkers start drinking in their 70s. "We are starting to make progress in understanding how to prevent and treat Alzheimer"s and other dementias," she said. "It is a very exciting time to be involved in geriatrics research." Jessica Guenzel Wake Forest University Baptist Medical Center


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